Summary
In the belief that the adrenal hyperplasia often seen in the children of diabetic mothers is associated with hyperfunction of the adrenal glands and that it may disturb the electrolyte balance and thereby also disturbs cardiac function, 15 children of diabetic mothers were examined. The investigation included an analysis of serial electrocardiograms traced in the neonatal period. In 4 cases the serum potassium was also determined. Abnormal electrocardiograms were seen in 11 cases. The electrocardiographic changes resembled those seen in hypopotassemia. The cause of this disturbance of the electrolyte metabolism is discussed.
Summary
Two cases of hemihypertrophy are described, in which Wilms's tumour was afterwards diagnosed. It is suggested that all children with hemihypertrophy should be examined urographically at least once every six months in order to detect the presence of any such a tumour in as early a stage as possible.
Hémihypertrophie et Tumeur de Wilms.
Description de deux cas d'hémihypertrophie chez lesquels une tumeur de Wilms fut découverte ultérieurement. Il est suggéré de pratiquer une urographie, au moins tous les 6 mois, ches les enfants atteints d'hémihypertrophie afin de détecter aussitot que possible l'existence d'une tumeur rénale éventuelle.
Hemihypertrophie und Wilms' Tumor.
Zwei Fälle von Hemihypertrophie sind beschrieben, bei denen Wilms' Tumor später diagnostiziert wurde. Es wird vorgeschlagen, dass alle Kinder mit Hemihypertrophie durch eine Urographie untersucht werden sollten, wenigstens einmal halbjährlich, um das Vorhandensein eines solchen Tumors in einem möglichst frühen Stadium aufzuklären.
Hemihipertrofia y tumor de Wilms.
Se describen dos casos de hemihipertrofia, en los cuales posteriormente se diagnosticó tumor de Wilms. Se sugiere que todos los niños con hemihipertrofia debieran ser examinados desde el punto de vista urológico, al menos una vez cada seis meses con el fin de detectar con la mayor precocidad posible dicho tumor.
Summary
Fulminating purpuric meningococcal septicaemia ‐with recovery cannot be separated clinically from the Waterhouse‐Friderichsen syndrome. The name Waterhouse‐Friderichsen Syndrome should be reserved for those cases in which the autopsy shows hemorrhages in the adrenal cortex. As the causative organism is not always the meningococcus the name fulminating purpuric septicaemia is suggested instead of fulminating purpuric meningococcal septicaemia. The author discusses the works of other investigators who assert that hemorrhages in the adrenal cortex are not always present in cases of fulminating purpuric meningococcal septicaemia, and that, where they occur, they are not likely to be of any consequence for the clinical picture or the outcome of the disease. The relation between the pituitary and the adrenals is discussed a‐nd data are compiled, pointing to the possible high endogenous ACTH production leading to high or maximal function of the adrenal cortex. It is the author's opinion that the fatal outcome in fulminating purpuric septicaemia is caused by the hyperacute infection, the shock, and the exhaustion of the adrenal cortex. If patients suffering from this disease are to have any chance of recovery, an early diagnosis, vigorous therapy against the infection, and substitutional therapy with adrenal cortical extract are essential.
Seven children with the nephrotic syndrome were treated with corticotrophin.
In all cases the treatment resulted in remission. The methods used and the observations on the excretion of steroids are reported.
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